Chest exam lung topography
Download
1 / 29

Chest Exam / Lung Topography - PowerPoint PPT Presentation


  • 235 Views
  • Uploaded on

Chest Exam / Lung Topography. Physical examination employs the use of inspection, palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy Each examination is modified according to the purpose of the examination

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Chest Exam / Lung Topography ' - jericho-nen


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  • Physical examination employs the use of inspection, palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Each examination is modified according to the purpose of the examination

  • Physical examination skills develop over time with practice


Examination of the head and neck
Examination of the Head palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapyand Neck

  • Identify the patient’s facial expression, looking for evidence of pain or acute distress

  • Look for evidence of cyanosis around the lips and oral mucosa

  • Patients may use pursed-lip breathing when COPD is present


Eyes palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • The eyes are inspected for pupillary response to light when neurologic defects are suspected

  • Dilated and fixed pupils suggest brain death in some patients

  • The eyelids may droop (ptosis), indicating damage to the third cranial nerve


Neck palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • The trachea should be midline

  • If it is deviated to one side, a unilateral lung problem is probably present

    • Atelectasis

    • pneumothorax

  • The status of the jugular veins in the neck is important

    • Patients with cor pulmonale have JVD

  • Use of accessory muscles in the neck suggests obstructive lung disease


Lung topography
Lung Topography palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Anterior chest is defined by the midsternal and midclavicular lines


Lung topography1
Lung Topography palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Lateral chest is defined by midaxillary, anterior axillary and posterior axillary lines


Lung topography2
Lung Topography palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Posterior chest is defined by the midspinal and midscapular lines


Thoracic cage landmarks
Thoracic Cage Landmarks palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy


Thoracic cage landmarks1
Thoracic Cage Landmarks palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • On the posterior chest, C7 is seen as the most prominent spinous process at the base of the neck


Thoracic cage landmarks2
Thoracic Cage Landmarks palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • The angle of Louis, or sternal angle, is located on the anterior chest.

    • Formed by the ridge between the manubrium and the gladiolus


Lung fissures
Lung Fissures palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • The oblique fissure

    • starts at rib six on the anterior chest at the midclavicular line

    • It runs up and laterally crosses the midaxillary line at fifth rib and across the posterior chest, ending at T3

  • horizontal fissure

    • passes from the fourth rib at the midsternal line laterally to the fifth rib in the midaxillary line


Tracheal bifurcation
Tracheal Bifurcation palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • At T4 on posterior chest

  • At sternal angle on anterior chest


Tracheal bifurcation1
Tracheal Bifurcation palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy


Diaphragm
Diaphragm palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • The diaphragm is a dome-shaped muscle

  • The top of the dome rests at about the fifth rib anteriorly and at T9 on the posterior chest normally


Lung borders
Lung Borders palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • On the anterior chest the upper border of the lung extends 2 to 4 cm above the medial third of the clavicles. The inferior border of the lung is at rib six normally


Lung borders1
Lung Borders palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • On the lateral chest the lower margin of the lung is at rib eight


Lung borders2
Lung Borders palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • On the posterior chest the superior border of the lung extends to T1. The inferior border varies with breathing but is usually at about T10


Examination of the thorax
Examination of the Thorax palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Look

  • Feel

  • Listen


Look for
Look For palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • A barrel chest or evaluate the A-P diameter

    • An in crease A-P diameter is consistent with COPD


Look for1
Look For palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Kyphoscoliosis is present when the spine is bent laterally and from front to back

    • Can causea restrictive lung problem


Look for2
Look For palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Pectus carinatum is seen as an abnormal sternal protrusion


Look for3
Look For palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Pectus excavatum is seen as depression of the sternum


Look for4
Look For palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Breathing pattern is important to identify when lung disease is present

  • Rapid and shallow breathing is consistent with restrictive disease

  • A prolonged expiratory time is consistent with obstructive lung disease

  • Retractions are seen as inward depression of the skin around the rib cage with inspiration

    • This suggests a high work of breathing (WOB)

  • Abdominal paradox is seen as inward movement of the abdomen with inspiration

    • This suggests diaphragm paralysis or fatigue

  • Hoover’s sign is seen as inward movement of the lateral chest with inspiration. It is a sign of severe COPD.


Feel for palpation
Feel For (Palpation) palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Vocal fremitus is assessed to identify pathologic changes in the lung.

  • Increased vocal fremitus is consistent with pneumonia and atelectasis.

  • Decreased vocal fremitus is consistent with lung hyperinflation, pleural disorders, and obesity.


Palpation
Palpation palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy


Palpation1
Palpation palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Use palpation to assess for uniform chest excursion


Percussion
Percussion palpation, percussion, and auscultation to determine patients’ clinical status and their response to therapy

  • Percussion is done to determine the condition of the underlying lung.

  • Increased resonance is heard with pneumothorax and lung hyperinflation.

  • Decreased resonance is heard with pneumonia and atelectasis.


ad